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Impact of an Innovative Interdisciplinary Conference

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Impact of an Innovative Interdisciplinary Conference Journal of Medical Education and Training Research Article Open Access Keywords: Interdisciplinary Conference; Gastroenterology Impact of an Innovative Fellowship Training; Medical Education; Image Recognition Interdisciplinary Conference Introduction Focused on High-Yield Images: Image recognition is an important skill for all gastroenterologists, particularly trainees. To diagnose most gastrointestinal and liver Significant Improvement in diseases, a combination of endoscopic, pathologic and radiologic Image Recognition Skills with knowledge is usually required. The American Gastroenterological Association’s (AGA) Core Curriculum has required training for all Gastroenterology, Radiology Gastroenterology Fellows in both Radiology and Pathology [1]. Specifically, in the section on the training of gastroenterologists in and Pathology Faculty Radiology, the Core Curriculum recommends that “trainees must have exposure at regular conferences that include radiographic Collaboration imaging studies in relation to gastrointestinal disease.” For Pathology, it advises that multidisciplinary conferences of gastroenterologists Pichamol Jirapinyo1,2*, Linda S. Lee1,2, Raquel O. Alencar3,2, and pathologists should be organized on a weekly or every other 4,2 3,2 4,2 Elizabeth Rinehart , Daniel A. T. Souza , Odise Cenaj , week basis to review specimens. In addition, the Core Curriculum Jerrold R. Turner4,2, Stephen Pelletier2, Molly L. Perencevich1,2, encourages assessment of knowledge in radiology and pathology. Helen M. Shields1,2 While single focused conferences in radiology or pathology are 1 Division of Gastroenterology, Hepatology and Endoscopy, Department of frequently included in the gastrointestinal (GI) fellows’ curriculum at Medicine, Brigham and Women’s Hospital, Boston, MA, USA individual programs and are an integral part of the fellowship training 2Harvard Medical School, Boston, MA, USA experience, either as a four week block or ongoing weekly established 3Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA conferences, at our GI fellowship program, we did not have specific 4Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA radiology and pathology conferences before this interdisciplinary conference was started in 2016. We are unaware of another *Corresponding author: Pichamol Jirapinyo, Email: [email protected] Gastroenterology program that has developed a specific conference to Received: 04 April 2020; Accepted: 12 May 2020; Published: 15 May 2020 help GI fellows recognize, not only GI endoscopy images, but also in the same conference receive training in the recognition of high-yield Abstract radiologic and pathologic images. Background: An innovative interdisciplinary conference focused It has been shown that learning in clinical settings alone is sometimes on recognition of high-yield images was established by faculty inadequate for trainees to acquire sufficient expertise. Previous studies from the Gastroenterology Division and Pathology and Radiology have explored the effect of additional educational offerings outside the Departments. clinical settings to augment this knowledge. For example, other groups have pioneered standardized educational programs to improve the Objective: To assess the effectiveness of the interdisciplinary endoscopic detection of early gastrointestinal cancers. The Asian Novel conference in improving image recognition skills. Imaging and Intervention Group organized a conventional classroom Methods: A prospective observational study. Primary Outcome: style program from November 2013 to March 2016 with a total of 41 Anonymous surveys assessed the effectiveness of the conference in workshops held in 13 different cities and countries in Asia. They were improving the perception of image recognition. Secondary Outcome: able to show a significant improvement in the post-test results compared Anonymous pre- and post-test scores assessed objective image to pre-test results for diagnosis of early esophageal neoplasia, early recognition. Statistics: A Likert scale was used to assess perceived gastric neoplasia and early colorectal neoplasia (p<0.0001) [2]. An improvement in image recognition. A paired Student’s t-test and a Chi- E-learning system was also used to improve the endoscopic diagnosis squared test were used to compare pre- and post-test scores and Likert of early gastric cancer worldwide. These investigators designed and scale scores, respectively. developed an international, randomized, controlled trial to evaluate the effectiveness of the E-learning system using video lectures and Results: Ten conferences were given between 2016 and 2018. self-exercise tests to gain experience in image recognition versus a A total of 51 out of 70 (72.9%) surveys were returned. 98% of the control group who did not receive E-Learning and showed that it led participants perceived the conference as “Extremely helpful” (59%) to a significant improvement (p<0.001) [3]. In addition to the benefits or “Very helpful” (39%) to their image recognition. Prior to the of teaching outside the clinical settings, prior studies have shown the conference, their comfort level with the subject matter was “Somewhat effectiveness of an interdisciplinary approach for teaching in various Comfortable” (comfort score of 2.5 ± 1.1). After the conference, their disciplines, such as Internal Medicine, Family Medicine, Mental Health comfort level increased to being “Very Comfortable” (comfort score Diseases and Medical Simulation [4-10]. of 4.0 ± 0.7) (p<0.0001). Participants’ surveys indicated a trend for the knowledge in the non-GI disciplines to improve the most (Pathology In this article, we describe a novel interdisciplinary conference 55%, Radiology 49%, Endoscopy 33%, p=0.08). At the beginning of created for gastroenterology fellows using faculty in endoscopy, the academic years, the average pre-test score on image recognition radiology and pathology. We then conducted a prospective study of GI skills of the gastroenterology fellows was 57% ± 19%. At the end of fellows to evaluate the effectiveness of this newly created conference at the academic year, the post-test score on the same images improved to improving self-reported image recognition skills and objective image- 70% ± 7% (p=0.0004). based pre- and post-test scores given at the beginning and at the end of Conclusion: An innovative, collaborative conference developed each academic year. by faculty experts in multiple disciplines focusing on high-yield endoscopic, pathologic and radiologic images was effective at improving objective and subjective image recognition skills. Copyright © 2020 The Authors. Published by Scientific Open Access Journals LLC. Jirapinyo P, et al. Volume 4, Issue 1 J Medic Educ Training 2020; 4:048 Methods Outcomes Study Design The primary outcome was the effectiveness of the conference in improving confidence in image recognition skills as assessed by The study was a prospective observational study conducted at anonymous paper surveys using a 5-point Likert scale (Appendix 1). an academic tertiary care center from September 2016 to May 2018. These surveys were given out at the beginning and collected at the end Interdisciplinary conference participants included gastroenterology of each conference from all participants including gastroenterology, (GI) fellows, GI pathology fellows, radiology residents and abdominal radiology and pathology residents and fellows. imaging and interventional radiology fellows. Attendance was voluntary. As each participant entered the conference, they were given The secondary outcome was fellows’ subjective perception of the Immediate Feedback Assessment Technique (IF-AT) (Epstein their level of readiness for the GI Training Examination (GTE) and the Educational Enterprises, Cincinnati, Ohio) card (Figure 1) [11]. Pre- and ABIM GI Board Examination. Subjective feedback on how to improve post-conference self-assessment tests were conducted on the subject of the conference was also collected, analyzed and used to improve the individual conference. An anonymous paper survey assessing the subsequent conferences (Appendix 1) Additionally, for only GI fellows, effectiveness of the conference and the quality of teaching was given to a cumulative image recognition test was administered at the beginning each participant at the end of each conference. of the academic year (2016-2017 and 2017-2018) and was compared to the scores at the end of the year (Appendix 2 and Appendix 3). These Gastroenterology fellows were invited to take an additional tests were given to all 14 general GI fellows at our institution during cumulative image recognition testing at the beginning and at the end each of the two consecutive years when the study was conducted. of the academic years 2016-2017 and 2017-2018. These tests focused on testing the knowledge on high-yield endoscopic, pathologic and Statistical Analysis radiologic images. All participants were given a random number in Perception of comfort with image recognition was assessed using order to keep the pre- and post-test results anonymous and assessed an anonymous paper survey with a Likert scale from 1 to 5 with 1 being for differences. The study was approved by the Partners Institutional “not at all comfortable” or “not at all helpful” and 5 being “extremely Review Board (IRB) in 2016. comfortable” or “extremely helpful.” The responses to this survey were Interdisciplinary Conferences with Faculty Collaboration analyzed using both a Student’s
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